Enrollment and Plan Coverage
Learn More About Your Coverage
With the Optima Health Plan, members may receive services at any participating provider in the Optima Health Vantage network throughout Virginia and Northeastern North Carolina. In order to enroll in the plan, employees must live or work in the Greater Hampton Roads area.
Find out if you can enroll by using our zip code tool or the enrollment map below:
Greater Hampton Roads region
Chesapeake Mathews Suffolk City of Franklin Newport News Surry Gloucester Norfolk Virginia Beach Hampton Poquoson Williamsburg Isle of Wight Portsmouth York James City Southampton
How do I know if I'm eligible for enrollment?
If you are a COVA or TLC employee who lives or works in the Greater Hampton Roads region as highlighted in the coverage map above then you are likely eligible for coverage under Optima Health Plan HMO for COVA and TLC employees. Alternatively, you can find out if the plan is available using our zip code tool.
Greater Hampton Roads region is defined as: Chesapeake, City of Franklin, Gloucester, Hampton, Isle of Wright, James City, Mathews, Newport News, Norfolk, Poquoson, Portsmouth, Southampton, Suffolk, Surry, Virginia Beach, Williamsburg, York. If you are in these areas then you are likely eligible for coverage under Optima Health Plan HMO for COVA and TLC employees. Additionally you must be eligible for health benefits coverage as defined by your employer.
How can I choose Optima Health?
Eligible COVA or TLC employees may enroll in the Optima Health Plan HMO through one of two methods:
- If you are an eligible COVA employee, you may enroll in the Optima Health Plan HMO by Employee Direct at: www.dhrm.virginia.gov or by completing and returning an enrollment form to your agency's benefits administrator.
- If you are an eligible TLC employee, check with your employer's benefits administrator for enrollment process details. Complete and return an enrollment form to your agency’s benefits administrator.
For COVA employees only: Learn more on how to enroll and make changes to your existing COVA Health Plan.
Does the plan coverage extend beyond Hampton Roads?
Yes. Members of the Optima Health Vantage HMO may receive services at any participating provider in the Vantage HMO network which covers the Commonwealth of Virginia and parts of northeastern North Carolina. The plan also includes out-of-area-dependent coverage for children living outside the state (for example away at college.)
If you are unsure about coverage in your area, then use the find doctors instructions to discover if network coverage is available in your area of interest.
In addition Virtual Visits are covered at no cost to you, when MDLive is accessed through Optima Health.
Do I have coverage while traveling outside of Virginia or the United States?
As part of your Optima Health Plan you can receive travel assistance that can handle your medical emergencies while on travel. You and any dependents on your Optima Health Plan are covered when traveling 100 miles or more away from your permanent residence, or to another country. Treatment and services, other than emergency services, received while traveling outside of the United States of America are not covered.
Last Updated: 1/2/2020